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The Clinical Spectrum Of Unruptured Intracranial Aneurysms.

E. Raps, J. Rogers, S. Galetta, R. Solomon, L. Lennihan, L. Klebanoff, M. Fink
Published 1993 · Medicine

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OBJECTIVE A retrospective study was performed to delineate the clinical characteristics of symptomatic unruptured aneurysms. DESIGN Patient histories, operative reports, and angiograms in 111 patients with 132 unruptured aneurysms were reviewed. SETTING Tertiary care university hospital. PATIENTS One hundred eleven patients with 132 unruptured intracranial aneurysms were studied. There were 85 women and 26 men, with a mean age of 51.2 years (age range, 11 to 77 years). Many patients were referred by community neurologists and neurosurgeons for further evaluation and neurosurgical management. RESULTS Fifty-four symptomatic patients were identified. Group 1 (n = 19; mean aneurysm diameter, 2.1 cm) had acute symptoms: ischemia (n = 7), headache (n = 7), seizure (n = 3), and cranial neuropathy (n = 2). Group 2 (n = 35; mean aneurysm diameter, 2.2 cm) had chronic symptoms attributed to mass effect: headache (n = 18), visual loss (n = 10), pyramidal tract dysfunction (n = 4), and facial pain (n = 3). Group 3 (n = 57; mean aneurysm diameter, 1.1 cm) had asymptomatic aneurysms. CONCLUSIONS Acute severe headache, comparable to subarachnoid hemorrhage headache, but without nuchal rigidity, was associated with the following mechanisms: aneurysm thrombosis, localized meningeal inflammation, and unexplained. Unruptured aneurysms may be misdiagnosed as optic neuritis or migraine, or serve as a nidus for cerebral thromboembolic events. Internal carotid artery and posterior circulation aneurysms were more likely to cause focal symptoms from mass effect than were anterior cerebral artery and middle cerebral artery aneurysms. Weeks to years may elapse before their diagnosis. The absence of subarachnoid blood does not exclude an aneurysm as a cause for acute or chronic neurologic symptoms.
This paper references
10.1016/0303-8467(89)90116-9
Unruptured aneurysms in patients with transient ischemic attack or reversible ischemic neurological deficit: Report of eight cases
K. Ohno (1989)
10.1016/S0090-3019(81)80049-3
Carotid-ophthalmic aneurysms: visual abnormalities in 32 patients and the results of treatment.
G. Ferguson (1981)
10.1016/0090-3019(86)90167-9
Rapidly growing aneurysm.
T. Yamaki (1986)
Incidence, aetiology, and prognosis of primary subarachnoid haemorrhage. A study based on 589 cases diagnosed in a defined urban population during a defined period.
S. Pakarinen (1967)
10.1212/WNL.30.1.47
Unruptured cerebral aneurysms presenting as recurrent transient neurologic deficits
R. M. Stewart (1980)
10.3109/02688698709034340
Clinical features and outcome in 48 patients with unruptured intracranial saccular aneurysms: a prospective consecutive study.
V. Eskesen (1987)
10.3171/JNS.1990.72.5.0677
Aneurysms of the ophthalmic segment. A clinical and anatomical analysis.
A. Day (1990)
10.3171/JNS.1973.38.5.0575
Warning signs prior to rupture of an intracranial aneurysm.
S. Okawara (1973)
10.1161/01.STR.21.4.555
Focal headache during balloon inflation in the internal carotid and middle cerebral arteries.
F. Nichols (1990)
10.3171/JNS.1990.73.1.0018
The International Cooperative Study on the Timing of Aneurysm Surgery. Part 1: Overall management results.
N. Kassell (1990)
10.1111/J.1600-0404.1967.TB05714.X
EPILEPSY, THE GREAT TEACHER
W. Penfield (1967)
10.3171/JNS.1965.22.2.0155
SACCULAR INTRACRANIAL ANEURYSMS: AN AUTOPSY STUDY.
W. Mccormick (1965)
10.1001/ARCHNEURPSYC.1926.02200300048003
ANEURYSMS OF CEREBRAL VESSELS: CLINICAL MANIFESTATIONS AND PATHOLOGY
H. Parker (1926)
10.1056/NEJM198103193041203
The natural history of unruptured intracranial aneurysms.
D. Wiebers (1981)
10.3171/JNS.1966.25.2.0219
SECTION V, PART I: Natural History of Subarachnoid Hemorrhage, Intracranial Aneurysms and Arteriovenous Malformations*
H. Locksley (1966)
10.1212/WNL.30.10.1034
The unchanging pattern of subarachnoid hemorrhage in a community
L. H. Phillips (1980)
10.1016/0090-3019(88)90121-8
Bilateral giant intracavernous aneurysms. Technique of unilateral operation.
H. Sano (1988)
10.1227/00006123-198803000-00021
Partially thrombosed aneurysm presenting as the sudden onset of bitemporal hemianopsia.
N. Aoki (1988)
10.1227/00006123-198102000-00020
Origin, growth, and rupture of saccular aneurysms: a review.
L. Sekhar (1981)
10.3171/JNS.1986.65.3.0411
MRI demonstration of clot in a small unruptured aneurysm causing stroke. Case report.
T. Eller (1986)
10.3171/JNS.1987.66.1.0023
The significance of unruptured intracranial saccular aneurysms.
D. Wiebers (1987)
10.3171/JNS.1966.25.2.0219
Natural history of subarachnoid hemorrhage, intracranial aneurysms and arteriovenous malformations. Based on 6368 cases in the cooperative study.
H. Locksley (1966)
10.3171/JNS.1983.59.4.0642
The long-term outcome in patients with multiple aneurysms. Incidence of late hemorrhage and implications for treatment of incidental aneurysms.
H. Winn (1983)
10.1016/0090-3019(88)90307-2
Rupture of a previously documented asymptomatic aneurysm enhances the argument for prophylactic surgical intervention.
R. Solomon (1988)
10.1212/WNL.36.4.584
Unruptured intracranial aneurysm and transient focal cerebral ischemia: a follow-up study
M. M. Przelomski (1986)
10.3171/JNS.1966.25.3.0321
Natural history of subarachnoid hemorrhage, intracranial aneurysms and arteriovenous malformations.
H. Locksley (1966)
10.1227/00006123-198803000-00020
Giant aneurysm arising from the anterior cerebral artery and causing an isolated homonymous hemianopsia.
M. Versavel (1988)
10.1177/003591575404700216
The Pathogenesis of Cranial Nerve Palsies Associated with Intracranial Aneurysms
H. H. Hyland (1953)
10.3171/JNS.1972.37.3.0361
Spontaneous thrombosis in a giant middle cerebral artery aneurysm. Case report.
R. Scott (1972)
10.1016/S0140-6736(86)92677-2
THUNDERCLAP HEADACHE: SYMPTOM OF UNRUPTURED CEREBRAL ANEURYSM
J. W. Day (1986)



This paper is referenced by
10.1046/j.1526-4610.2003.03211.x
Effect of Endovascular Treatment on Headaches in Patients With Unruptured Intracranial Aneurysms
A. Qureshi (2003)
10.1016/S0733-8619(05)70125-0
Medicolegal issues: headache.
J. Saper (1999)
10.1007/s10194-005-0159-0
Migraine with aura, bipolar depression, ACM aneurysm. A case report
S. De Filippis (2005)
10.1007/s00005-009-0010-4
TNF-α and sICAM-1 in intracranial aneurismal rupture
A. Witkowska (2009)
10.12816/EJHM.2019.50260
Endovascular Treatment of Un-Ruptured Cerebral Aneurysms (Experience by Neurologist)
E. Khedr (2019)
10.1136/bmj.322.7298.1347
Playing the odds in clinical decision making: lessons from berry aneurysms undetected by magnetic resonance angiography
M. Johnson (2001)
10.1016/j.parkreldis.2013.11.012
Basilar artery aneurysm presenting with hemiparkinsonism.
Hosam Al-Jehani (2014)
10.1016/j.wneu.2018.02.034
Self-Reported Headaches in Patients with Unruptured Intracranial Aneurysms Treated with the Pipeline Embolization Device.
Anna M Schneider (2018)
10.1177/1358863X18754693
Intracranial aneurysms: Review of current science and management
G. Toth (2018)
10.1097/00006123-200205000-00016
Detection of Microemboli by Transcranial Doppler Ultrasonography in Aneurysmal Subarachnoid Hemorrhage
J. Romano (2002)
10.3174/ajnr.A1382
Thunderclap Headache without Subarachnoid Hemorrhage Associated with Regrowth of Previously Coil-Occluded Aneurysms
E. Byrum (2009)
10.1155/2015/153714
Embolic Signals during Routine Transcranial Doppler Ultrasonography in Aneurysmal Subarachnoid Hemorrhage
F. M. Paschoal (2015)
10.1159/000145335
Interpeduncular Basilar Aneurysm Causing Progressive Locked-In Syndrome: To Coil or Not to Coil
Saud Khan (2008)
[Diagnosis and differential diagnosis of demyelinating optic neuropathy in multiple sclerosis].
Gennady Bisaga (2012)
10.1016/J.ANCLIN.2007.06.002
Anesthetic considerations for intraoperative management of cerebrovascular disease in neurovascular surgical procedures.
R. Avitsian (2007)
10.1016/J.JEMERMED.2007.10.003
Aneurysmal subarachnoid hemorrhage: update for emergency physicians.
J. Edlow (2008)
10.1097/MD.0000000000006084
Headache improvement after intracranial endovascular procedures in Chinese patients with unruptured intracranial aneurysm
Linjing Zhang (2017)
SLOVENSKO ZDRAVNIŠKO DRUŠTVO SEKCIJA ZA HIPERTENZIJO
Sekcije Za Hipertenzijo (2012)
10.3171/JNS.1995.83.3.0421
Clinical study of enlarged infundibular dilation of the origin of the posterior communicating artery.
S. Endo (1995)
10.7326/0003-4819-132-1-200001040-00026
Headache and Facial Pain
W. Young (2000)
10.2176/NMC.50.788
Symptomatic unruptured cerebral aneurysms: features and surgical outcome.
I Date (2010)
10.1016/j.wneu.2015.05.069
Surgical Treatment of Middle Cerebral Artery Aneurysms Without Using Indocyanine Green Videoangiography Assistance: Retrospective Monocentric Study of 263 Clipped Aneurysms.
S. Hallout (2015)
10.1016/S1052-3057(97)80016-X
Treatment of unruptured aneurysms.
J. G. Frazze (1997)
10.1177/1358836X9800300407
Management of intracranial aneurysms
S. Chang (1998)
10.1002/brb3.997
Prediction of vascular abnormalities on CT angiography in patients with acute headache
I. M. Alons (2018)
10.1001/ARCHNEUR.1994.00540170019007
Unruptured aneurysms and headache.
D. Wilkins (1994)
Original Contributions ANEURYSMAL SUBARACHNOID HEMORRHAGE : UPDATE FOR EMERGENCY PHYSICIANS
J. Edlow (2008)
10.1046/j.1468-1331.2003.00645.x
Clinical warning criteria in evaluation by computed tomography the secondary neurological headaches in adults
D. Aygun (2003)
10.1016/j.nic.2013.03.007
Endovascular methods for the treatment of intracranial cerebral aneurysms.
J. Gemmete (2013)
10.1016/S1474-4422(14)70015-8
Unruptured intracranial aneurysms: epidemiology, natural history, management options, and familial screening
R. D. Brown (2014)
10.1007/s00415-014-7464-y
Hippocampal damage and affective disorders after treatment of cerebral aneurysms
Maria Wostrack (2014)
10.1016/j.annemergmed.2007.10.025
Is the combination of negative computed tomography result and negative lumbar puncture result sufficient to rule out subarachnoid hemorrhage?
J. Perry (2008)
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